William Shelton Jr., D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22D100868900 Issued in NJ

Practice address

202 Fairmount Ave
Newark, NJ 07103-2455

Phone

(917) 656-7012

Fax

(212) 780-0895

NPI assigned

Apr 19, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1639523319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 FAIRMOUNT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032455",
            "telephone_number": "917-656-7012",
            "fax_number": "212-780-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 FAIRMOUNT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032455",
            "telephone_number": "917-656-7012",
            "fax_number": "212-780-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22D100868900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelton Dental PA
• Shelton Dental PA
• Shelton Oral Surgery PA
• Bryannah Shelton
• Godfrey P Shelton, D.M.D.
• Sherry Manon Sheppard, MD
• Harkaran Shergill, MD
• James P Sheridan, DC
• Katherine Irene Sheridan, MD
• Corey Sherlock, APN

• Oral and Maxillofacial Surgery (Dentist) in Newark, NJ
• Providers in Newark, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.